D-dimer for assessment of treatment response, and survival to drug-eluting beads transarterial chemoembolization in hepatocellular carcinoma

• Published in: Clinics and research in hepatology and gastroenterology Vol. 47; no. 4; p. 102096
• Main Authors: Duan, Youjia, Hou, Xiaopu, Guo, Jiang, Li, Honglu, Cai, Liang, Cheng, Long, Zhao, Wenpeng, Shao, Xihong, Du, Hongliu, Diao, Zhenying, Li, Changqing
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.04.2023
• Subjects: Carcinoma, Hepatocellular - pathology; Chemoembolization, Therapeutic - adverse effects; D-dimer; Drug-eluting bead transarterial chemoembolization; Hepatocellular carcinoma; Humans; Liver Neoplasms - pathology; Survival; Treatment Outcome; Treatment response; D-dimer; Hepatocellular carcinoma; Treatment response; Survival; Drug-eluting bead transarterial chemoembolization; Drug-eluting beads transarterial chemoembolization
• ISSN: 2210-7401; 2210-741X
• DOI: 10.1016/j.clinre.2023.102096

•Detection of D-dimer in hepatocellular carcinoma patients before and after DEB-TACE.•Elevated D-dimer level was related to tumor burden and poor liver function.•High levels of D-dimer estimated lower complete response to DEB-TACE therapy.•High levels of D-dimer could forecast shorter overall survival to some degree.•The D-dimer level was increased during DEB-TACE therapy. D-dimer exhibits a certain prognostic value in hepatocellular carcinoma (HCC) patients who underwent hepatectomy and microwave ablation, while its value in estimating the clinical benefit of drug-eluting beads transarterial chemoembolization (DEB-TACE) remains unclear. Hence, this study aimed to investigate the correlation of D-dimer with tumor features, response and survival to DEB-TACE in HCC patients. Fifty-one HCC patients treated with DEB-TACE were recruited. Their serum samples at baseline and after DEB-TACE were collected and proposed for D-dimer detection by the immunoturbidimetry method. Elevated D-dimer levels were related to a higher Child‒Pugh stage (P = 0.013), tumor nodule number (P = 0.031), largest tumor size (P = 0.004), and portal vein invasion (P = 0.050) in HCC patients. Then, patients were classified by the median value of D-dimer, and it was observed that patients with D-dimer >0.7 mg/L achieved a lower complete response rate (12.0% vs. 46.2%, P = 0.007) but a similar objective response rate (84.0% vs. 84.6%, P = 1.000) compared to those with D-dimer ≤0.7 mg/L. The Kaplan‒Meier curve showed that D-dimer >0.7 mg/L (vs. ≤0.7 mg/L) was related to shorter overall survival (OS) (P = 0.013). Further univariate Cox regression analyses showed that D-dimer >0.7 mg/L (vs. ≤0.7 mg/L) was related to unfavorable OS [hazard ratio (HR): 5.524, 95% confidence interval (CI): 1.209–25.229, P = 0.027], but it failed to independently estimate OS (HR: 10.303, 95%CI: 0.640–165.831, P = 0.100) in multivariate Cox regression analyses. Moreover, D-dimer was elevated during DEB-TACE therapy (P<0.001). D-dimer may be helpful for monitoring prognosis to DEB-TACE therapy in HCC, while further large-scale-study validation is warranted.